People’s Pharmacy: Stopping medication abruptly not a good idea

Q. I was alarmed to read that a caring, concerned grandmother had stopped her grandson’s medication for ADHD abruptly. This could be extremely dangerous.

I stopped taking Adderall myself after having been on it for some time, but only after I asked my physician. With some medications, it might not be OK just to stop.

A. You are right to point out that stopping medication requires medical supervision. It makes sense to ask the doctor about when and how to stop medicine even before beginning to take a prescription.

The grandmother who wrote us described a complicated situation. When we edited out some details for space considerations, we inadvertently implied that she had stopped her grandson’s medicine without medical oversight.

Q. I told my physician that my penis bends as an erection occurs. He laughed and suggested that this was not uncommon at my age (71) and that only extensive surgery could possibly correct it.

Now I’ve heard that there are medications that might help. My wife says that it’s a bit uncomfortable, but tolerable.

A. Your description fits Peyronie’s disease. Experts estimate that it affects approximately 8 percent of men over 50. Peyronie’s is caused by scarring on one side of the erectile body of the penis.

Urologist Culley Carson, M.D., tells us that medications can sometimes be helpful. They include pentoxifylline (a drug that makes platelets flexible and improves blood circulation) and colchicine (a drug used primarily for gout). The calcium channel blocker verapamil is sometimes injected directly into the scar tissue. Such treatments must be supervised by a specialist. You can listen to an interview with Dr. Carson at www.peoplespharmacy.com (show No. 668).

Q. I have atrial fibrillation, an abnormal heart rhythm for which I take Tambocor (a heart rhythm drug) and warfarin (a blood thinner). I also have arthritis. I was taking Tylenol for it, but my lab tests went haywire. I think the Tylenol was affecting the warfarin, because after I stopped taking it my bleeding time results came back into balance.

I know warfarin is crucial to prevent a stroke, but I find it very challenging to figure out all the conflicting information about it. I had been told that Tylenol would be fine, but it isn’t. I’ve also heard different advice about cranberry juice and vegetables. Can you send me any information on warfarin and diet?

A. Warfarin, also prescribed by the brand names Coumadin or Jantoven, is a lifesaving drug, but it can be tricky to use. It interacts with many other medicines and even many foods. While acetaminophen (Tylenol) could be used for occasional pain relief, regular use can raise the INR (a measure of blood coagulation) and increase the risk of dangerous bleeding.

Cranberries may also increase the risk of bleeding, while vegetables rich in vitamin K, such as brussels sprouts or kale, can counteract warfarin’s action and increase the risk of a blood clot.

We are sending you our Guides to Food, Drug and Coumadin Interactions for more details on this important medication. Anyone who would like copies, please send $2 in check or money order with a long (No. 10), stamped (58 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. FD-195, P.O. Box 52027, Durham, NC 27717-2027. They also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.